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General NPI Number Information
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NPI Number | 1225998164
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Entity Type | Individual
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Provider Name | BLANCA GRANADOS
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Gender |
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Dates
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Enumeration Date | 11/13/2025
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | 3511 CAMINO DEL RIO S STE 301
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City | SAN DIEGO
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State | CA
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Zip | 92108-4020
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Country | US
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Telephone | 619-500-1843
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Fax |
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Provider Business Mailing Address
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Address Line | 830 KUHN DR
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City | CHULA VISTA
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State | CA
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Zip | 91914-3514
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | AMFT159346
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License Number State | CA
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